Individual
DR. SUZILIENE AYANNA BOARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1788 WILMINGTON PIKE, SUITE 107, GLEN MILLS, PA 19342-8181
(610) 952-4558
Mailing address
1788 WILMINGTON WEST CHESTER PIKE, SUITE 107, GLEN MILLS, PA 19342
(610) 952-4558
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS015303
PA
103TS0200X
School Psychologist
9847267
PA
Other
Enumeration date
12/05/2006
Last updated
10/26/2009
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